NCCIH teases framework on whole-person health

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The National Center for Complementary and Integrative Health (NCCIH) announced it is developing a framework for determinants of health with a whole-person perspective, according to a note by Helen Langevin, MD, director of the NCCIH.

The framework, Langevin said, will encompass four domains within the whole-person health concept: biological, behavioral, social, and environmental. The goal is to help drive a paradigm shift and create a pragmatic tool that supports rigorous and consistent approaches to whole-person health studies.

Two working groups, one internal to the National Institutes of Health (NIH) and one external to the NIH with representatives from whole health or integrative health organizations have been partnering with the NCCIH in developing this framework. The agency also incorporated feedback from the scientific community by publishing a request for information, asking respondents to suggest a limited number of determinants that best define the health/disease continuum from the whole-person health perspective. They received 83 responses.

Additionally, the agency obtained insights in other ways, including public workshops and by observing the Veterans Health Administration’s Whole Health concept and similar models used by the military health system.

One of the many challenges of developing such a framework is that hundreds of determinants could be reasonably considered. It also must account for other preexisting or developing frameworks, such as social determinants of health and behavioral risk factors. The NCCIH will combine its findings and feedback to ensure the most crucial determinants are captured in the framework.

The agency will also host its Stakeholder Meeting for Research on Whole Person Health on October 17 and 18, which will serve as another opportunity to hear more about gaps in whole-person health research, and what is needed to implement whole-person health in the real world. 

The NCCIH said it anticipates being able to share the final framework in the coming months. Once the framework is finalized, the agency will establish a set of common data elements—variables that can be measured in consistent ways through questionnaires, electronic health record data, laboratory tests, or other approaches—to assess each determinant. Having common data elements will help move research forward by guiding study design and making it possible to combine and compare results from multiple studies.